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Question 1. In a population of 534,533 White male roadside construction workers, 436 died from Lung Disease in 1980. Is this mortality experience from Lung Disease greater than, less than, or about the same as that which you would expect in White males of the same ages in the general population? Use Table 1 to answer the question.

Question 2. Given that the crude death rate in White male roadside construction workers is 11 per 1000, what is the Indirect Adjusted Mortality Rate (IAR) of the White male roadside construction workers compared to the general population of White males?

TABLE 1: Data on White Male Disease on Mortality 

Age (Yrs)

Estimated Population for White Male Roadside Construction Workers

Death Rate Per 100,000 from Lung Disease in White Males (General Population)

Expected Deaths from Lung Disease in White Roadside Construction Workers (If Same Risk as General Population)

Observed Deaths from Lung Disease in White Roadside Construction Workers (If Same Risk as General Population)

20-24

74,598

12.26

 

10

25-29

85,077

15.45

 

20

30-34

80,845

22.55

 

22

35-44

148,870

34.84

 

98

45-54

102,649

57.57

 

112

55-59

42,494

74.31

 

174

Question 3. The total population in 2003 was 290,810,789 (males = 143,037,290; females=147,773,499). For 2003, the total number of live births was 4,089,950.

Total Mortality from Selected Causes, Males and Females, United States, 2003

Causes of Death

Males 

Females

Total

All Causes

1,201,964

1,246,324

2,448,288

Accidents

70,532

38,745

109,277

Malignant Neoplasms

287,990

268,912

556,902

Alzheimer's Disease

18,335

45,122

63,457

Infant Deaths

15,902

12,123

28,025

Maternal Deaths

NA

495

495

a) Calculate the crude death rates (per 100,000) and the cause-specific death rates (per 100,000) for accidents, malignant neoplasms, and Alzheimer's Disease. Repeat these calculations for males and females separately. Place your answers in the table below.

 

 

Male Death

Rate (per 100,000)

 

Female Death Rate (per 100,000)

 

Total Death Rate (per 100,000)

All Causes

1,201,964

 

1,246,324

 

2,448,288

 

Accidents

70,532

 

38,745

 

109,277

 

Malignant Neoplasms

287,990

 

268,912

 

556,902

 

Alzheimer's Disease

18,335

 

45,122

 

63,457

 

b) What are the Proportional Mortality Ratio (PMRs) (Percent) for accidents, malignant neoplasms, and Alzheimer's Disease? Repeat these calculations for males and females separately. Place your answers in the table below.

 

Males

Females

Total

Accidents

 

 

 

Malignant Neoplasms

 

 

 

Alzheimer's Disease

 

 

 

c) Calculate the maternal mortality rate (per 100,000 live births).
d) Calculate the infant mortality rate (per 1000 live births).
e) Calculate the crude birth rate (per 1000 population).

Question 4. In case-control studies, the odds ratio is used as an estimate of the relative risk. In order for this approximation to be reasonable, some conditions must be met. Which of the following conditions is not necessary in order to use the odds ratio to estimate the relative risk?
a. With respect to exposure, controls are representative of the population to which you want to generalize your results.
b. The event (disease) under study is rare in the population.
c. Cases are representative of all cases.
d. The exposure in question is rare in the population.

Question 5. An epidemiologic survey of Motor Vehicle Accidents (MVA) in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year:

Number of drivers in Metroville during any given month

12,000

Total number of residents injured from MVA

1,800

Total number of deaths from MVA

90

Total number of deaths from all causes

900

The proportional mortality ratio (%) due to motor vehicles was:
a. 90/1,800 x 100
b. 90/100,000 x 100
c. 90/600 x 100
d. 90/900 x 100

Question 6. An epidemiologic survey of Motor Vehicle Accidents (MVA) in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year:

Number of drivers in Metroville during any given month

12,000

Total number of residents injured from MVA

1,800

Total number of deaths from MVA

90

Total number of deaths from all causes

900

The crude death rate for all causes was:
a. 90/600 x 100,000
b. 900/100,000 x 100,000
c. 90/1,800 x 100,000
d. 90/900 x 100,000

Question 7. A large medical center's oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital's epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption. The resulting data are as follows:

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

Tea Drinking

140

110

230

225

Coffee Drinking

190

140

270

240

Note: Total number of male cancer patients = 200.
Total number of female cancer patients = 150.
Total number of male patients (other diseases) = 300.
Total number of female patients (other diseases) = 300.
Which number best approximates risk associated with Coffee Drinking in Men?
a. 1.02
b. 3.50
c. 0.94
d. 2.11
e. 0.63

Question 8. A large medical center's oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital's epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption. The resulting data are as follows:

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

Tea Drinking

140

110

230

225

Coffee Drinking

190

140

270

240

Note: Total number of male cancer patients = 200.
Total number of female cancer patients = 150.
Total number of male patients (other diseases) = 300.
Total number of female patients (other diseases) = 300.

Which number best approximates risk associated with Coffee Drinking in Women?
a. 0.94
b. 3.50
c. 0.63
d. 2.11
e.1.02

Question 9. A large medical center's oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital's epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption.

The resulting data are as follows:

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

Tea Drinking

140

110

230

225

Coffee Drinking

190

140

270

240

Note: Total number of male cancer patients = 200.
Total number of female cancer patients = 150.
Total number of male patients (other diseases) = 300.
Total number of female patients (other diseases) = 300.

Does this study have an exposure status variable?
a. No
b. Yes, disease type
c. Insufficient information to answer this question
d. Yes, sex of patient
e. Yes, lifestyle

Question 10. A large medical center's oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital's epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption.

The resulting data are as follows:

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

Tea Drinking

140

110

230

225

Coffee Drinking

190

140

270

240

Note: Total number of male cancer patients = 200.
Total number of female cancer patients = 150.
Total number of male patients (other diseases) = 300.
Total number of female patients (other diseases) = 300.

Which number best approximates risk associated with alcohol drinking in men?
a 0.71
b. 0.92
c. 2.11
d.1.37
e. 0.62

Question 11. A large medical center's oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital's epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption.

The resulting data are as follows:

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

Tea Drinking

140

110

230

225

Coffee Drinking

190

140

270

240

Note: Total number of male cancer patients = 200.
Total number of female cancer patients = 150.
Total number of male patients (other diseases) = 300.
Total number of female patients (other diseases) = 300.

What type of study is this?
a. Cohort
b.Experimental
c. Clinical trial

d. Case-control

e. Intervention

Question 12. A case-control study is purely a descriptive (as opposed to analytic) study design.

a. True
b. False

Question 13.

a. This type of study is the strongest at proving or disproving association and allows the researcher to control exposure to cases and controls. Examples of this type of study include clinical trials for vaccines.

b. Examples of this type of a study include BRFSS, NHANES, PRAMS.

c. This is not a study but a form of epidemiology that includes analyzing rates, proportions, and ratios.

d. This type of study is most often used with testing a null hypothesis for an outbreak since you know the outcome/disease and who are the cases.

e. This is the weakest study but can be the start to further testing the association between a risk/exposure and disease/disability/death.

f. This type of study follows a group of people over a length of time to determine if certain exposures result in certain outcomes. Example of this type of study is the Framingham Nurse Study.

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